Canivet J L, Piret S, Hick G, Damas P
Service de Soins Intensifs Généraux, CHU de Liège, Domaine Universitaire du Sart Tilman, B35, 4000 Liège.
Acta Anaesthesiol Belg. 2004;55(2):125-7.
We describe an unusual case of cardiac tamponade and pulmonary compression due to acute volvulus of colon interposition occuring late after oesophagectomy. Clinical signs were suggestive of cardiac tamponade but there was no evidence of pericardial effusion by transthoracic echocardiography. Thoracic-CT provided the diagnostic clue in revealing the extrapericardial nature (a major dilatation of the colonic transplant) of the tamponade. This diagnosis should be considered in case of acute cardiopulmonary distress occuring early or late after oesophagectomy.
我们描述了一例不寻常的病例,该病例为食管切除术后晚期发生的结肠间置急性扭转导致心脏压塞和肺受压。临床体征提示心脏压塞,但经胸超声心动图未发现心包积液的证据。胸部CT揭示了压塞的心包外性质(结肠移植的严重扩张),从而提供了诊断线索。对于食管切除术后早期或晚期出现的急性心肺窘迫病例,应考虑这一诊断。